Ethnic Differences in Children’s Entry into Public Mental Health Care via Emergency Mental Health Services

There is increasing evidence that delay in the commencement of treatment, following the onset of schizophrenia, may be related to the pathways patients navigate before accessing mental health care. Therefore, insight into the pattern and correlates of pathways to mental care of patients with schizophrenia may inform interventions that could fast track their contact with mental health professionals and reduce the duration of untreated psychosis. This study assessed the pathways to mental health care among patients with schizophrenia (n=138), at their first contact with mental health services at the Federal Neuro-Psychiatric Hospital Yaba Lagos, Nigeria. Traditional and religious healers were the first contact for the majority (69%) of the patients. Service users who first contacted nonorthodox healers made a greater number of contacts in the course of seeking help, eventuating in a longer duration of untreated psychosis (P<0.001). However, the delay between the onset of psychosis and contact with the first point of care was shorter in patients who patronized nonorthodox practitioners. The findings suggest that collaboration between orthodox and nonorthodox health services could facilitate the contact of patients with schizophrenia with appropriate treatment, thereby reducing the duration of untreated psychosis. The need for public mental health education is also indicated.

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Pathways to the First Contact with Specialist Mental Health Care

Australian & New Zealand Journal of Psychiatry ◽

10.1080/j.1440-1614.2006.01801.x ◽

2006 ◽

Vol 40 (4) ◽

pp. 347-354 ◽

Cited By ~ 42

Author(s):

Zachary Steel ◽

Robert Mcdonald ◽

Derrick Silove ◽

Adrian Bauman ◽

Phil Sandford ◽

...

Keyword(s):

Mental Health ◽

Social Support ◽

Health Care ◽

Mental Health Services ◽

Health Services ◽

Mental Health Care ◽

Public Mental Health ◽

Explanatory Models ◽

Public Mental Health Services ◽

First Contact

Objective: To examine the pathways to mental health care followed by patients presenting for the first time to community- and hospital-based services and the degree to which individual characteristics, cultural background, illness type, severity and service-related variables influence the time and pathways taken to reach care. Method: One hundred and forty-six consecutive Australian-born, Asian and Arabicspeaking patients making their first lifetime contact with mental health services in two area health regions were included. Symptom severity was assessed using the Health of the Nations Outcome Scales. Illness explanatory models, social support, English-language proficiency and acculturation were also assessed. Results: An average of three professional consultations were made prior to first contact with public mental health services. Family physicians occupied a pivotal role in the helpseeking pathway with 53% of patients consulting a general practitioner. The median time taken to reach specialist mental health services was 6 months, with significantly shorter time for patients with psychotic disorders. Individual variables such as gender, social support, ethnicity and English flency were not associated with delays in receiving public mental health care. Ethnicity was associated with lower utilization of allied health professionals. Conclusions: The data suggest that social and cultural factors influence the range of professionals consulted by those with a mental illness but do not delay their presentation to public mental health services.

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COVID-19, psychosocial issues, politics, and public mental health care

South African Journal of Psychology ◽

10.1177/00812463211015750 ◽

2021 ◽

Vol 51 (2) ◽

pp. 293-303

Author(s):

Anthony L Pillay ◽

Anne L Kramers-Olen

Keyword(s):

Mental Health ◽

South Africa ◽

Health Care ◽

Mental Health Care ◽

Health Care Systems ◽

Mental Health Policy ◽

Public Mental Health ◽

The Public ◽

Care Systems ◽

Public Mental Health Care

The COVID-19 pandemic heralded challenges that were both significant and unfamiliar, placing inordinate burdens on health care systems, economies, and the collective psyche of citizens. The pandemic underscored the tenuous intersections between public mental health care, politics, economics, and psychosocial capital. In South Africa, the inadequacies of the public health system have been laid bare, and the disproportionate privileges of the private health care system exposed. This article critically considers government responses to the COVID-19 pandemic, the psychosocial correlates of lockdown, politics, corruption, and public mental health policy in South Africa.

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Prevalence and Predictors Limited Literacy in Public Mental Health Care

Community Mental Health Journal ◽

10.1007/s10597-020-00750-0 ◽

2021 ◽

Author(s):

Alisa K Lincoln ◽

Mara Eyllon ◽

Christopher Prener ◽

Suzanne Garverich ◽

John Griffith ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Public Mental Health ◽

Limited Literacy ◽

Public Mental Health Care

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Asian Americans and Mental Health: Cultural Barriers to Effective Treatment

Elements ◽

10.6017/eurj.v1i1.8880 ◽

2005 ◽

Vol 1 (1) ◽

Cited By ~ 2

Author(s):

Heather K. Speller

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Services ◽

Health Services ◽

Mental Health Care ◽

Asian American ◽

Racial Minorities ◽

Cultural Barriers ◽

Real Problem ◽

Surgeon General

Disparities in mental health care for racial minorities remains a serious and very real problem calling for immediate attention. The 2001 report of the Surgeon General affirmed that ethnic and racial minorities have less access to and availability of mental health services, and are subsequently less likely to receive needed mental health services. This paper examines a range of issues regarding Asian American mental health. It presents the practical and cultural barriers that members of this ethnic group confront when seeking mental health care and explains how cultural differences sometimes result in misdiagnosis and ineffective treatment. It also explores ways that the American mental health care system can improve to accommodate diverse ethnic groups.

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Shared decision making in public mental health care: Perspectives from consumers living with severe mental illness.

Psychiatric Rehabilitation Journal ◽

10.2975/34.1.2010.29.36 ◽

2010 ◽

Vol 34 (1) ◽

pp. 29-36 ◽

Cited By ~ 46

Author(s):

Emily M. Woltmann ◽

Rob Whitley

Keyword(s):

Mental Health ◽

Health Care ◽

Decision Making ◽

Mental Illness ◽

Mental Health Care ◽

Severe Mental Illness ◽

Shared Decision Making ◽

Public Mental Health ◽

Shared Decision ◽

Public Mental Health Care

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Converging perspectives of providers and student users on extending a patient portal into a university-based mental health service: A qualitative study

10.26686/wgtn.12331235.v1 ◽

2020 ◽

Author(s):

N Gasteiger ◽

Theresa Fleming ◽

K Day

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Service ◽

Mental Health Services ◽

Health Service ◽

Qualitative Study ◽

Health Services ◽

Mental Health Care ◽

Patient Portal ◽

Patient Portals

© 2020 The Authors Background: Patient portals have the potential to increase access to mental health services. However, a lack of research is available to guide practices on extending patient portals into mental health services. This study explored stakeholder (student service users' and health providers') expectations and perceptions of extending patient portals into a New Zealand university-based mental health service. Materials and methods: This qualitative study explored the perspectives of 17 students and staff members at a university-based health and counselling service on an Internet-based patient portal through a software demonstration, two focus groups and 13 interviews. Data were analyzed thematically. Results: Staff and students perceived the patient portal as useful, easy to use and expected it to help make mental health care more accessible. Staff were most concerned with the portal's ability to support their triage processes and that it might enable students to ‘counselor hop’ (see multiple counselors). Staff recommended extension into services that do not require triage. Most students expected the portal to enhance patient-counselor contact and rapport, through continuity of care. Students were concerned with appointment waiting times, the stigmatization of poor mental health and their capacity to seek help. They considered the portal might assist with this. Students recommended extension into all services, including urgent appointments. After viewing findings from initial student and staff groups, staff concluded that extending a patient portal into their counseling services should be prioritized. Conclusion: This research suggests that there is value in extending patient portals into mental health care, especially into low-risk services. Future research should explore opportunities to support triage and appointment-making processes for mental health services, via patient portals.

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Operational challenges in conducting a community-based technology-enabled mental health services delivery model for rural India: Experiences from the SMART Mental Health Project

Wellcome Open Research ◽

10.12688/wellcomeopenres.14524.1 ◽

2018 ◽

Vol 3 ◽

pp. 43

Author(s):

Pallab K. Maulik ◽

Sudha Kallakuri ◽

Siddhardha Devarapalli

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Services ◽

Health Services ◽

Mental Health Care ◽

Rural India ◽

Operational Strategies ◽

Health Services Delivery ◽

Services Delivery ◽

Health Project

Background: There are large gaps in the delivery of mental health care in low- and middle-income countries such as India, and the problems are even more acute in rural settings due to lack of resources, remoteness, and lack of infrastructure, amongst other factors. The Systematic Medical Appraisal Referral and Treatment (SMART) Mental Health Project was conceived as a mental health services delivery model using technology-based solutions for rural India. This paper reports on the operational strategies used to facilitate the implementation of the intervention. Method: Key components of the SMART Mental Health Project included delivering an anti-stigma campaign, training of primary health workers in screening, diagnosing and managing stress, depression and increased suicide risk and task sharing of responsibilities in delivering care; and using mobile technology based electronic decision support systems to support delivery of algorithm based care for such disorders. The intervention was conducted in 42 villages across two sites in the state of Andhra Pradesh in south India. A pre-post mixed methods evaluation was done, and in this paper operational challenges are reported. Results: Both quantitative and qualitative results from the evaluation from one site covering about 5000 adults showed that the intervention was feasible and acceptable, and initial results indicated that it was beneficial in increasing access to mental health care and reducing depression and anxiety symptoms. A number of strategies were initiated in response to operational challenges to ensure smoother conduct of the project and facilitated the project to be delivered as envisaged. Conclusions: The operational strategies initiated for this project were successful in ensuring the delivery of the intervention. Those, coupled with other more systematic processes have informed the researchers to understand key processes that need to be in place to develop a more robust study, that could eventually be scaled up.

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